The therapist's action
The therapist's action is essentially on the skin. Indeed, as Diane Jacobs points out so well, it is impossible to touch anything other body structure than the skin. No matter what structure we project mentally, our hands only touch the skin. And that's fine, because the skin contains thousands (probably hundreds of thousands would be more accurate) of receptors that link our hands to the patient's brain. It is up to us to know how to use them and to learn how to do it well, we must necessarily go through a thorough study of neurophysiology.
The Skin according to Dr J.-C. Guimberteau
By its structure and by its function as a carrier of the other sense organs, the skin is more than an organ. It is a set of different organs, perfectly introducing the notion of anatomical, physiological, cultural and, therefore, psychological complexity. Of all the senses, touch is the most vital. One can live without smell, vision, deprived of taste, but not without the skin. It signals constantly. The skin does not close, it does not stop, the skin never sleeps. It has a smell, a grain, it perspires, secretes, eliminates. It ensures signal exchanges with the outside world, so the body surface is a communicating machine as much as a protective membrane.
Attention Versus Intention
The intention is present at the beginning, as soon as one chooses to become a therapist (or another profession related to "taking care"). The intention to help the person and the desire to see his condition, and his quality of life, improve are the basis and we cannot have a better intention for one or the other. That is totally part of our commitment.
But for our intervention to be effective, we must take into account the biopsychosocial aspect of our patient and the quality of the gesture itself. I have to give it my full attention, and do what neurophysiology suggests, the best I can. Therefore, it becomes essential to pay attention to the patient (presence to him), and to pay attention to the way we are going to touch (presence to oneself).